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The Flowers Care Home Limited Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 29 October 2019

During a routine inspection

About the service

The Flowers is a residential care home providing personal care to 23 people and specialises in the care of people living with dementia. Most people who use the service are aged 65 or over. At the time of our inspection there were 17 people living at the home.

People’s experience of using this service and what we found

People’s medicines were not always managed safely. There was no evidence of harm, but people were at risk of not always receiving their medicines as prescribed. We found the provider was in breach of regulation.

There were enough staff to keep people safe. However, there were times when staff were busy and appeared rushed. This had not led to people experiencing unsafe care and we saw staff were always kind and patient when supporting people. We recommended the provider keep staffing numbers under review and ensure they were changed to take account of people’s changing needs.

Improvements were needed to the way the provider checked the quality and safety of the services provided. The checks they carried out were not always effective in identifying shortfalls and areas for improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff knew people well and respected their privacy and dignity.

People’s dietary needs and preferences were catered for. The service worked with other professionals such as the district nurses to make sure people’s health care needs were addressed.

People’s needs were assessed, and their care plans included information about their needs and preferences. This supported the delivery of person-centred care. People were supported to take part in a range of appropriate activities inside and outside the home.

The home was clean and decorated in a homely style.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 16 March 2017

During a routine inspection

This inspection was carried out on the 16 March 2017. The Flowers Care Home is registered to provide accommodation and personal care for up to 23 people and specialises in caring for people who are living with dementia. There were 20 people living at the home on the day of inspection. The home is located in a residential area close to local shops and other amenities. There is a bus route nearby. There are two shared bedrooms, the remaining are single rooms. Some bedrooms have en-suite facilities.

Our last inspection took place on 16 June 2015 and at that time we found the home was not meeting two of the regulations we looked at. These related to ‘safe care and treatment’ and ‘good governance’. The service was rated ‘Requires Improvement’ overall. This inspection was therefore carried out to see if any improvements had been made since the last inspection.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found care records were regularly updated and staff were provided with the information they needed to meet people’s needs. People’s care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare.

Robust recruitment procedures were in place which ensured only staff suitable to work in the caring profession were employed. Staff received the training, support and supervision they needed to carry out their roles effectively.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Staff were able to tell us how they supported people to make their own decisions and the registered manager was aware of the process to follow should a person lack the capacity to consent to their care and treatment.

We saw staff had received training in safeguarding adults and were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing policy (reporting poor practice) in place and told us they were certain any concerns they raised would be taken seriously by the registered manager.

Staff encouraged and supported people to lead their lives as independently as possible whilst ensuring they were kept safe. People’s medicines were managed in a safe way. Accidents and incidents were recorded and action taken to reduce the risks to people.

We found the registered manager and staff we spoke with were able to tell us about the people who used the service, knew their likes and dislikes and things that were important to them. Staff supported people nutritional and hydration needs and ensured they had access to other health care professionals when needed.

There was a robust quality assurance monitoring in place to help improve the quality of the service provided. The provider actively sought, encouraged and supported people's involvement in the improvement of the service.

There was a complaints procedure for people to voice their concerns. People who were able and/or their relatives told us they had no complaints but were confident that they would be listened to and action would be taken to resolve any problems they may have in the future.

Inspection carried out on 16/06/2015

During a routine inspection

The Flowers Care Home is registered to provide accommodation and personal care for up to 23 people and specialises in caring for people who are living with dementia. There were 21 people living at the home on the day of inspection. The home is located in a residential area close to local shops and other amenities. There is a bus route nearby. There are two shared bedrooms, the remaining are single rooms. Some bedrooms have en-suite facilities.

We inspected The Flowers Care Home on 16 June 2015 and the visit was unannounced. Our last inspection took place in January 2014 and at that time we found the service was meeting the regulations we looked.

The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GPs, hospital consultants, community health nurses, opticians, chiropodists and dentists.

We found the registered person did not have a medicines policy in place which conformed to current guidance and medication was not always administered at the time prescribed.

We saw there was a staff recruitment and selection policy in place. However, the recruitment policy was not dated and did not show the procedures the provider took to ensure only people suitable to work in the caring profession were employed. However, when we looked at the staff files it was apparent the registered manager operated a robust system.

In addition, the majority of policies, procedures and environmental risk assessments in place had not been reviewed on a regular basis and therefore it was difficult to establish if they provided staff with accurate and up to date information. The registered manager was also unable to find the electrical wiring certificate for the premises and was unsure when this test had last been carried out.

People’s care plans and risk assessments were person centred and the staff we spoke with were able to tell us how individuals preferred their care and support to be delivered. Care plans and risk assessments were reviewed on a regular basis to make sure they provided accurate and up to date information and were fit for purpose.

There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. The staff we spoke with had a general working knowledge and understanding of the MCA 2005. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one when required.

We saw staff were patient and caring toward people in their care. People who were able told us they were happy living at The Flowers Care Home and were complimentary about the staff. However, the relatives of two people who used the service told us they had some concerns about the level of support people received with their personal care.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or treatment they received.

We found the quality assurance monitoring systems in place were not robust as shortfalls in the service highlighted in the body of this report had not been identified through the audits carried out by the registered manager or provider.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.